Nonomura K, Fujieda K, Sakakibara N, Terasawa K, Matsuno T, Matsuura N, Koyanagi T
J Urol. 1984 Sep;132(3):595-8. doi: 10.1016/s0022-5347(17)49755-2.
Luteinizing hormone releasing hormone and human chorionic gonadotropin tests were performed to examine the pituitary gonadal axis in 31 prepubertal boys with hypospadias. Luteinizing hormone and follicle stimulating hormone responses to luteinizing hormone releasing hormone in these boys with hypospadias were significantly higher than those in prepubertal control subjects (luteinizing hormone, p less than 0.01). follicle stimulating hormone, p less than 0.05). Prepubertal boys with hypospadias had remarkably reduced testosterone responses to human chorionic gonadotropin stimulation compared to controls (p less than 0.01). Hormonal milieus were further analyzed in the subtypes of hypospadias depending on their severity (distal vs. proximal). Nine of the 31 boys with hypospadias were classified as the proximal type. Basal luteinizing hormone levels in the proximal type were significantly higher than in the distal type (p less than 0.05). Luteinizing hormone and follicle stimulating hormone responses to luteinizing hormone releasing hormone and responses of testosterone to human chorionic gonadotropin were not significantly different in the 2 types. Seven of the 31 boys with hypospadias had a history of maternal progestin ingestion. Basal luteinizing hormone levels and responses of luteinizing hormone and follicle stimulating hormone to luteinizing hormone releasing hormone were also significantly higher in these subjects than in controls (p less than 0.005), though basal levels and responses of testosterone to human chorionic gonadotropin were not different from those of controls. Tests conducted to determine luteinizing hormone and follicle stimulating hormone and testosterone levels using luteinizing hormone releasing hormone and human chorionic gonadotropin stimulation revealed no statistical differences between the boys with hypospadias who had a history of maternal progestin ingestion and those without such a history. The majority of prepubertal boys with hypospadias had varying degrees of deficient testicular activity. The testicular function of these patients should be evaluated longitudinally at puberty and thereafter in order to insure the completion of secondary sexual development.
对31名患有尿道下裂的青春期前男孩进行了促黄体生成素释放激素和人绒毛膜促性腺激素测试，以检查垂体 - 性腺轴。这些患有尿道下裂的男孩对促黄体生成素释放激素的促黄体生成素和促卵泡激素反应显著高于青春期前对照受试者（促黄体生成素，p<0.01；促卵泡激素，p<0.05）。与对照组相比，患有尿道下裂的青春期前男孩对人绒毛膜促性腺激素刺激的睾酮反应显著降低（p<0.01）。根据尿道下裂的严重程度（远端型与近端型）对其亚型进行了进一步的激素环境分析。31名患有尿道下裂的男孩中有9名被归类为近端型。近端型的基础促黄体生成素水平显著高于远端型（p<0.05）。两种类型对促黄体生成素释放激素的促黄体生成素和促卵泡激素反应以及睾酮对人绒毛膜促性腺激素的反应无显著差异。31名患有尿道下裂的男孩中有7名有母亲服用孕激素的病史。这些受试者的基础促黄体生成素水平以及促黄体生成素和促卵泡激素对促黄体生成素释放激素的反应也显著高于对照组（p<0.005），尽管睾酮对人绒毛膜促性腺激素的基础水平和反应与对照组无差异。使用促黄体生成素释放激素和人绒毛膜促性腺激素刺激来测定促黄体生成素、促卵泡激素和睾酮水平的测试显示，有母亲服用孕激素病史的尿道下裂男孩与无此病史的男孩之间无统计学差异。大多数患有尿道下裂的青春期前男孩有不同程度的睾丸活动不足。这些患者的睾丸功能应在青春期及之后进行纵向评估，以确保第二性征发育完成。
